HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME: Take the course for this article: Volume 67, Number 9, November 14, 2006 Turkish Data Supplement Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ikram, M. A. Articles by Breteler, M. M.B. Search for Related Content PubMed PubMed Citation Articles by Ikram, M. A. Articles by Breteler, M. M.B. Related Collections All Cerebrovascular disease/Stroke Infarction All epidemiology Risk factors in epidemiology Cardiac

Unrecognized myocardial infarction and the risk of stroke

The Rotterdam Study

From the Department of Epidemiology and Biostatistics (M.A.I., M.H., M.J.B., A.H., J.C.M.W., M.M.B.B.), Department of Medical Informatics (J.A.K.), and Department of Neurology (P.J.K.), Erasmus MC, The Netherlands.

Address correspondence and reprint requests to DrB. Breteler, Department of Epidemiology and Biostatistics, Erasmus Medical Center, Dr Molewaterplein 50, 3015 GE, Rotterdam, The Netherlands; e-mail: m.breteler{at}erasmusmc.nl

Objective: To investigate the relationship between unrecognized myocardial infarction and the risk of stroke in a population-based cohort study.

Methods: We followed 6,439 participants from the Rotterdam Study for stroke until January 2002. Participants were free from stroke, and presence of myocardial infarction was assessed at baseline (1990–1993). We calculated hazard ratios of stroke for persons with unrecognized or recognized myocardial infarction compared with persons without myocardial infarction. Analyses were adjusted for age, sex, and cardiovascular risk factors.

Results: In 52,915 person-years of follow-up, 505 strokes occurred. Recognized myocardial infarction was only borderline associated with an increased risk of stroke. Unrecognized myocardial infarction increased the risk of stroke by 76% (age- and sex-adjusted hazard ratio 1.76, 95% CI 1.31 to 2.37). Stratification by sex showed that the increased risk was only found in men (hazard ratio for men 2.53, 95% CI 1.68 to 3.81; hazard ratio for women 1.27, 95% CI 0.82 to 1.96). After adjusting for cardiovascular risk factors at baseline, the risk remained significantly increased in men (hazard ratio for stroke 2.13, 95% CI 1.35 to 3.36). Subtyping of strokes revealed that unrecognized myocardial infarction was particularly associated with cortical ischemic strokes (hazard ratio for men 3.57, 95% CI 1.79 to 7.12).

Conclusions: Men with unrecognized myocardial infarction have an increased risk of stroke.

Disclosure: The authors report no conflicts of interest.

Received April 3, 2006. Accepted in final form July 21, 2006.

This article has been cited by other articles:

				M. D. M. Haag, M. J. Bos, A. Hofman, P. J. Koudstaal, M. M. B. Breteler, and B. H. C. Stricker Cyclooxygenase Selectivity of Nonsteroidal Anti-inflammatory Drugs and Risk of Stroke Arch Intern Med, June 9, 2008; 168(11): 1219 - 1224. [Abstract] [Full Text] [PDF]

				M. A. Ikram, M. van Oijen, F. J. de Jong, J. A. Kors, P. J. Koudstaal, A. Hofman, J. C.M. Witteman, and M. M.B. Breteler Unrecognized Myocardial Infarction in Relation to Risk of Dementia and Cerebral Small Vessel Disease Stroke, May 1, 2008; 39(5): 1421 - 1426. [Abstract] [Full Text] [PDF]